Tuesday, August 21, 2012

We Aren't Robbing Peter to Pay Paul

Those costs are expected to run $1.8 million over budget this year. Some of that may be a result of sloppy management – without an in depth analysis, there’s no way to tell.

But there’s no question that some of it is being driven, as Sheriff Paul Pastor maintains, by the high cost of dealing with inmates with serious psychiatric illnesses.

According to the Sheriff’s Department, which operates the jail, roughly 118 inmates with serious mental illnesses are being confined there at any given time. Some of them are housed in a section of the building that’s been turned into what amounts to a psychiatric wing. Others are held maximum security.

An additional 150 or more don’t suffer from acute illnesses – but are sick enough to require psychiatric medications. The jail’s budget for mental health treatment, coincidentally, is $1.8 million.

In my book My Brother Ron, I make the claim that it isn't clear that deinstitutionalization of the mentally ill actually saved any money. That was never anything but a secondary concern, anyway, but today, when I make the point that we need to be willing to spend money on mental health care, the question that I am asked is, "Where's the money going to come from?" The answer is that we are already spending the money--but not on mental hospitals, but psychiatric wards of jails and prisons, on programs to provide very temporary assistance to the mentally ill homeless, and for the small fraction who become local or national headlines, murder trials, followed by years in prison.

These other ways of spending money are generally less efficient, and often less humane than what we had before: state mental hospitals that, for all their faults, at least did not have mentally ill people freezing to death on a winter's night, or dying of pneumonia.

I would call this misallocation of resources "robbing Peter to pay Paul," but that does not capture the full horror of it. Because about 10% of murders in the U.S. are done by severely mentally ill offenders, many of whom were already known to be mentally ill, and the costs of murder trials and subsequent prison terms are long and costly, we aren't robbing Peter to pay Paul. We are murdering Peter to pay Paul.

1 comment:

Speaking of misallocation of resources I ran across this rant and I wonder how accurate it is. It is a problem that genuinely mentally ill people are often too messed up to jump through the hoops required to get help.